Performance of the Dexamethasone Suppression Test in Depressive Illness According to ICD and DSM-III Classification Systems

1988 ◽  
Vol 152 (4) ◽  
pp. 554-558 ◽  
Author(s):  
Sarah Watkins ◽  
Brian Harris ◽  
Nigel Cook ◽  
Roger Thomas ◽  
Diana Riad-Fahmy

The performance of the dexamethasone suppression test was assessed in 90 consecutive admissions with a diagnosis of depression, categorised according to two classification systems (DSM-III and ICD-9). Non-suppression was found in most of the diagnostic categories, but there was a highly significant association with the DSM-III classification ‘major depressive episode with melancholia’ (52%) in comparison with the ICD group ‘manic-depressive illness-depressed’ (29%).

1982 ◽  
Vol 36 (2) ◽  
pp. 109-114
Author(s):  
Masakazu Sarai ◽  
Norio Taniguchi ◽  
Takao Kagomoto ◽  
Hideaki Kameda ◽  
Takeshi Uema ◽  
...  

1984 ◽  
Vol 18 (3) ◽  
pp. 277-279 ◽  
Author(s):  
Allen Fraser

This study compares the utility of a cortisol suppression index with the standard dexamethasone suppression test as a diagnostic aid for major depressive disorder. In 50 patients the cortisol suppression index was found to have similar sensitivity while also having greater specificity and diagnostic confidence than the dexamethasone suppression test. By avoiding the need for a late-evening blood sample, the cortisol suppression index may be an acceptable alternative to the current procedure.


1984 ◽  
Vol 145 (1) ◽  
pp. 88-90 ◽  
Author(s):  
Alec Coppen ◽  
Janet Harwood ◽  
Keith Wood

SummaryThe dexamethasone suppression test (DST) was carried out on 143 patients with a major depressive disorder, who were classified into those with a history of weight loss (n = 89) and those without (n = 54). Seventy-three per cent of patients with weight loss and 61% of patients without had an abnormal DST; this difference was not statistically significant. Of the patients receiving prophylactic lithium therapy, 13 were found to have changed their DST status on retesting after a period of 14 months, but there was no significant difference in their weight. It is concluded that weight loss is not a necessary condition for an abnormal DST in depressive illness.


1987 ◽  
Vol 150 (4) ◽  
pp. 459-462 ◽  
Author(s):  
Alec Coppen ◽  
Maryse Metcalfe

The response to the dexamethasone suppression test (DST) was examined in 543 patients suffering from major depressive illness and 246 healthy controls, from 13 research centres, representing 12 different countries, in a World Health Organization Collaborative Study. In almost all the centres, the post-dexamethasone plasma Cortisol concentration was significantly higher in the patients than in the controls. Although there is variation between centres, this abnormal response to the DST was shown to be frequent in patients from widely different geographical areas.


1987 ◽  
Vol 150 (3) ◽  
pp. 315-318 ◽  
Author(s):  
C. L. E. Katona ◽  
C. R. Aldridge ◽  
Martin Roth ◽  
J. Hyde

Twenty-six in-patients satisfying DSM-III criteria for major depressive episode were assessed using the Newcastle Diagnostic and ECT Predictor Scales and the dexamethasone suppression test (DST), prior to commencing a course of electroconvulsive therapy (ECT). The Newcastle ECT Predictor Scale was successful in predicting both immediate outcome and outcome over the 6 months following ECT; the DST was unsuccessful in predicting either immediate or 6-month outcome.


1983 ◽  
Vol 142 (5) ◽  
pp. 498-504 ◽  
Author(s):  
A. Coppen ◽  
M. Abou-Saleh ◽  
P. Milln ◽  
M. Metcalfe ◽  
J. Harwood ◽  
...  

SummaryThe prevalence of an abnormal response to the dexamethasone suppression test (DST) was examined in 119 in-patients suffering from a major depressive disorder and in 79 normal controls. Only 11 per cent of controls showed an abnormal DST as against 70 per cent of depressed patients. The specificity of the DST was examined by testing patients with other psychiatric disorders. Abnormal responses were found in one-fifth of a sample of schizophrenics, over one-quarter of abstinent alcoholics, two-fifths of neurotics (including neurotic depressives) and almost half of senile dements. Abnormal DST was also found in 33 per cent of patients receiving prophylactic lithium for recurrent affective disorders.


1982 ◽  
Vol 140 (3) ◽  
pp. 292-304 ◽  
Author(s):  
Bernard J. Carroll

SummaryMelancholia is thought by many investigators to have a biological basis, and biological research, particularly on abnormalities of the neuroendocrine system and of the sleep electroencephalogram, is now beginning to yield results which can help in the differential diagnosis of depressive illness. This review will focus on the most widely studied neuroendocrine disturbance: disinhibition of the hypothalamus-pituitary-adrenal cortex (HPA) system as revealed by the dexamethasone suppression test (DST).


1982 ◽  
Vol 27 (5) ◽  
pp. 390-396
Author(s):  
Michael H. Stone

The currently most popular definitions of “borderline” are those of Kernberg, Gunderson and Spitzer (now incorporated into the DSM-III). The Kernberg criteria define a level of function (between “Neurotic” and “Psychotic”); the Gunderson criteria, a more narrowly circumscribed clinical syndrome, phenomenologically distinct from schizophrenia and from the psychoneuroses. The DSM-III criteria are derived from these and other sources and define a broad domain that includes the other usages of “borderline.” Even the narrower definitions of borderline describe a collection of conditions heterogeneous with respect to hereditary, constitutional and psychosocial factors. Genetic, biochemical and clinical research suggests the appropriateness of dividing the borderline domain into a variety of sub-types. The largest proportion of borderline cases are effective (with prominent depressive symptoms; occasionally, with cyclothymic or hypomanic symptoms). Of these, some show strong “endogenous” features, as well as family pedigrees of manic-depressive illness. This category includes many patients with anorexia nervosa or with agoraphobia. In others, the affective symptoms seem more related to severe psychosocial stresses in early life (including physical abuse, parental deprivation, or incest). Smaller proportions within the borderline domain are occupied by schizotypal cases (many with hereditary linkage to core schizophrenia), or by organic cases (including temporal lobe epilepsy, or minimal brain damage, giving rise to the “episodic dyscontrol” syndrome). Biochemical and nerophysiological markers that may be useful in distinguishing among the borderline subtypes include measure of platelet MA O-activity, of dexamethasone suppression, of R.E.M. latency, motion-sickness susceptibility and of average evoked response to photic stimulation. Attention to subtypes is important in considering optimal treatment for borderline patients. Not all respond to analytically-oriented psychotherapy alone. Those with severe affective symptoms often require antidepressant medication or lithium. Affectively ill borderlines usually have a better prognosis than schizotypals. In cases of episodic dyscontrol, anti-epileptic drugs may be useful.


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